Intermittent Claudication

Intermittent Claudication is classified as an occlusive disease. It is primarily a peripheral vascular disorder. The underlying cause is due to an atherosclerotic process that affects the blood vessels of the lower extremities. This process can also affect the blood vessels of the upper extremities. When this occurs, the diseases or disorders caused, are different in name, such as,

Raynaud’s disease, scleroderma and Buerger’s disease

This discussion will primarily be the intermittent claudication of the lower extremities. This is a condition that can be insidious at best. It can start slowly without the individual being aware of its start. As the symptoms progress, the individual realizes that something is wrong when walking for a short distance, they will start getting pain in the calf of one or both legs.

Depending on the rapidity of the development of the occlusive process occurring in the blood vessels of the lower extremities, the degree of the symptoms will progress. This progression can be insidious as previously stated, or occur in a more rapid nature depending on how much more the blood vessels become occluded.

As pain, ache, cramp or tiredness occurs on walking, the individual will find that when they stop walking, the pain will ease in 2 to 5 minutes. When they start walking, the symptoms will resume. As the disease progresses with the progression of the blood vessel occlusion, the individual will find that the painful symptoms will occur faster and the distance walked is much shorter.

The occlusion of the venous system causes the lower extremities to become very warm and red. Very often swelling occurs due to the accumulation of fluids (edema). This is also called venous stasis. This condition can also affect the left ventricle of the heart. Should this occur, the heart has to pump harder to circulate the blood throughout the body, causing a rise in the diastolic (lower) blood pressure?

Intermittent claudication can take another form other than the occlusion of the blood vessels and this would be due to the nerves that transmit impulses to the blood vessels, causing them to contract or dilate as the case may be. This is called “Neurogenic claudication”. When causing them to contract in a severe, sustained manor the symptoms are very similar to those caused by athersclerosis of the blood vessels? The similarity differs in that they will occur at times when walking and will not occur at other times. Spinal stenosis may play a role in this condition. This is a condition that affects the spinal column whereby nerves become impinged due to foramina encroachment. This is narrowing of the opening where the spinal nerves exit.

As the disease progresses, the individual, starts to feel a tiredness and heaviness of the legs in addition to the pain, ache, spasms and cramps that occur on walking. They may find that it can take the pain a little longer to dissipate on resting. Other symptoms will become apparent as well. The individual will not be able to walk as much as a few steps before the pain comes on. They will not be able to walk in a rapid manner or walk uphill. The toes and the entire foot may start to show extreme color changes, such as redness or blanching, and could develop ulcers. If left without treatment, necrosis (tissue death) that can lead to gangrene is a distinct possibly. This can lead to amputation if not aggressively treated.

Intermittent claudication in any form is a condition that should not be ignored. The consequences if left untreated can be very devastating at best. At any of the initial signs of this condition, the individual seek the advice of their healthcare provider. A definitive diagnosis has to be made and treatment started.

The individual can also help in their treatment of this disorder by following these other suggestions:

1. Stop smoking if you are a smoker. This is a must!
2. If you are a drinker, you must curb the amount of alcohol you drink. Men can have 2 glasses of wine daily. Women can allow themselves 1 glass of wine on a daily basis. Consumption of more alcohol causes constriction of the blood vessels that will aggravate the condition.
3. Diet is critical in that you must lower your cholesterol intake by cutting transfats and fatty foods from your diet. This means severely cutting out red meats, fried foods, butter, solid margarine, cakes, cookies and most junk foods. Vegetables and fruits need to be increased to at least 5 portions of fruits and 4 portions of vegetables.
4. Exercise will play an extremely important role in helping alleviate the condition and its symptoms. Part of your exercise program should be walking. The amount of walking should be several times on a daily basis. The individual may have some difficulty at first and not be able to walk very far, but as they follow the above suggestions and walk a little longer distance each time, the distance will increase and the symptoms will not occur as quickly, and gradually become less severe. Walk for at least 30 minutes daily and gradually raise that to 60 minutes. If pain occurs at any time, stop and rest until the  pain goes away. When it does resume your walking.
5. Institute the following exercise. Lay on your back. Raise the legs pointing towards the ceiling. Move your feet up and down and keep this up for up 2 minutes or as long as you can up to the 2 minutes. Lower your legs and repeat the above 3 times. Gradually increase to 6 times.
6. When sitting, place pillows under your legs so the legs are higher than the heart.
7. When sitting on a chair, or while driving, be sure that your thighs are not having pressure placed upon them. The seating should be such that the front of the seat is in a downward mode, so there will not be any pressure placed on the thighs.

Seeing your healthcare provider, listening to his/her advice, and following the above procedures can greatly improve the condition and symptoms of intermittent claudication.